Sep 12, 2010 1:00pm EDT
this is a letter we got from maxim u.s. we're federal services. experts on appeals. medicare hired us to review this file and decide if the partd plan made the correct decision. we work for medicare. we do not work for part-d plan. we appealed and my wife won wholly. so the administrative law judge process. maxim u.s. has appealed that a decision and they say according to the term medically accepted indication includes only fda uses and those off dated uses supported by citation on one of the listed drugs. more over, medically accepted indication does not including treating physician testimony or proffer of medical efforts showing a drug as prescribed effectively treats the condition for which it's being used. converse easily could have included expert testimony as a source material for determining medically accepted uses if he wanted to do so. instead congress by reference to a drugs fda label and expert opinions in one of several drug. accordingly. medical accept the use is not the same as medically necessary. >> i would like to, we worked on issues like that so. we could be of help to you.